A novel Artificial Intelligence-based tool to assess anticholinergic burden: a survey

Agostina Secchi, Hulkar Mamayusupova, Saber Sami, Ian Maidment, Simon Coulton, Phyo Kyaw Myint, Chris Fox

Research output: Contribution to journalArticlepeer-review


BACKGROUND: many medications possess anticholinergic activity. Their use is associated with a number of serious adverse effects including cognitive effects. The cumulative anticholinergic effect of medications as assessed by tools such as the anticholinergic burden scale (AchB) can identify people particularly at risk of anticholinergic side-effects. Currently, >20 tools are available for clinicians to use, but there is no consensus on the most appropriate tool.

METHODS: a newly created online tool-International Anticholinergic Cognitive Burden Tool (IACT)-based on natural language processing and chemical structure analysis, was developed and made available for clinicians to test its functions. We carried out a survey (between 8th of February and 31st of March 2021) to assess the overall need for an assessment tool as well as the usability of the IACT.

RESULTS: a total of 110 responses were received from different countries and practitioners' groups. The majority of the participants (86.11%) stated they would use a tool for AchB assessment if available and when they were asked to rate the IACT against other tools, amongst 34 responders, 20.59% rated it better and 8.82% rated it significantly better, 44.12% rated it neither better, nor worse, 14.71% rated it worse and 11.76% somewhat worse.

CONCLUSION: there is a need for an anticholinergic burden calculator to assess the anticholinergicity of medications. Tools such as the IACT potentially could meet this demand due to its ability to assign scores to current and new medications appearing on the market based both on their chemical structure and reported adverse pharmacological effects.

Original languageEnglish
Article numberafac196
Number of pages4
JournalAge and Ageing
Issue number8
Publication statusPublished - 27 Aug 2022

Bibliographical note

© The Author(s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

Funding: This work was funded by EIRA (Enabling Innovation: Research to Application) at UEA and Research England and Eastern AHSN.


  • adverse events
  • anticholinergic
  • older people
  • polypharmacy


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